Exaggerated adrenarche and hyperinsulinism in adolescent girls born small for gestational age

Serum dehydroepiandrosterone-sulfate (DHEAS) is a classic marker for adrena rche and subsequently, for the individual hormonal milieu. We have tested t he hypothesis that prenatal growth reduction is followed by exaggerated adr enarche. Serum DHEAS, androstendione and insulin concentrations were determ ined together with fasting glycemia in matched populations of asymptomatic, non-obese, post-menarcheal girls (mean age 14 yr) who were born either wit h a strictly appropriate weight for gestational age (AGA) or small for gest ational age (SGA). When compared to AGA girls, the SGA girls had identical glucose levels, higher values for insulin and androstenedione (p < 0.01), a nd a two-fold rise of DHEAS concentrations (p < 0.0001). In conclusion, gir ls with prenatal growth reduction were found to be prone to develop, beside s hyperinsulinism, a variant of exaggerated adrenarche. It remains to be ve rified whether the exaggerated adrenarche in adolescence is followed by adr enal hyperandrogenism throughout adulthood and senescence.